Individual
MRS. LEILANI DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25385 MAIN ST, ARDMORE, TN 38449-3155
(931) 427-2143
Mailing address
25385 MAIN ST, ARDMORE, TN 38449-3155
(931) 427-2143
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4338
TN
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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